tci E/M Coding Alert - 2019 Issue 4

You Be the Coder: Know This New Patient E/M Rule

Question: I have a new patient present with impacted cerumen removal. Since this patient is brand new to the practice, may the provider bill for the E/M service in addition to the cerumen removal? Illinois Subscriber Answer: According the American Academy of Otolaryngology — Head and Neck Surgery (AAO-HNS), there are four criteria that you must meet to bill for both services: “The initial reason for the patient’s visit was separate from the cerumen removal; Otoscopic examination of the tympanic membrane is not possible due to the impaction; Removal of the impacted cerumen requires the expertise of...

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